Accuracy of self-reports of Pap and mammography screening compared to medical record: a meta-analysis
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OBJECTIVES: To conduct a systematic review and meta-analysis of the accuracy of self-reported Pap smear and mammography screening compared to medical record. METHODS: About 37 articles were reviewed and accuracy indices of self-report were calculated. Meta-analysis with random effects was used. Study heterogeneity was investigated and meta-regressions were done including in the models those factors that were hypothesized, a priori, to potentially explain heterogeneity. RESULTS: Pooled sensitivity and specificity for Pap recall were 94.7% (95% confidence interval [CI]; 93.0%-96.4%) and 47.4% (95% CI; 39.0%-55.7%), and for mammography were 94.9% (95% CI; 93.4%-96.4%) and 61.8% (95% CI; 54.1%-69.5%), respectively. There was significant heterogeneity for all indices. Stratifying by the study population source (population versus clinic-based), population characteristics (minority or low socio-economic status versus not), length of recall (within past 12 months versus longer), and expected completeness of the medical record (authors searched radiology or pathology reports of all likely facilities women may have attended, versus studies that did not) did not eliminate heterogeneity. CONCLUSIONS: Women tend to over-report their participation in Pap and mammography screening in a given timeframe. The pooled estimates should be interpreted with caution due to unexplained heterogeneity.